Summary
Today, the House is expected to pass the Senate-approved measure increasing the debt ceiling, giving lawmakers until early December to reach a longer-term deal or pass another short-term fix. December 3 is when the U.S. is projected to hit the debt ceiling and when the continuing resolution funding the federal government for fiscal year 2022 expires.
As for infrastructure, October 31 is the deadline set by House Speaker Nancy Pelosi (D-CA) for the House to vote on the bipartisan infrastructure package passed by the Senate. Meanwhile, Democrats are negotiating a trimmed down budget reconciliation package – with a possible price tag between $1.5 trillion (Sen. Joe Manchin’s (D-WV) topline number) and the original $3.5 trillion. There is less certainty on how exactly the health care priorities – expanding Medicare benefits, address the Medicaid expansion coverage gap, extending premium subsidies, and lowering prescription drug prices – may be scaled back.
In a Dear Colleague letter sent yesterday, Speaker Pelosi signaled that Democrats may cut entire provisions from the bill rather than shortening their authority. For example, Democrats may cut the expansion of Medicare benefits rather than further delaying their effective date. Pelosi said, “Overwhelmingly, the guidance I am receiving from Members is to do fewer things well so that we can still have a transformative impact on families in the workplace and responsibly address the climate crisis: a Build Back Better agenda for jobs and the planet For The Children!”
COVID-19 Vaccine
Later this week (October 14-15), the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee will discuss the Emergency Use Authorization (EUA) of the Moderna and Johnson & Johnson COVID-19 vaccine booster for adults. The FDA could make a final decision on the EUA within days of the meeting. The Centers for Disease Control and Prevention (CDC) has scheduled a two-day meeting next week (October 20-21) to discuss the Moderna and Johnson & Johnson boosters.
Regulatory Update
A number of key rules are now under review at the Office of Management and Budget (OMB). On the Medicare payment front, two key final rules – the Hospital Outpatient Prospective Payment System (HOPPS) and End Stage Renal Disease Prospective Payment System (ESRD PPS) – arrived last week for review. Both final rules may potentially drop later next month. As a reminder, the major provisions of note we may see in these final rules are as follows:
- HOPPS: The proposed rule included provisions that would raise fines for hospitals that do not publish their list of standard charges – a requirement pursuant to the Hospital Price Transparency rule. The rule may also include a number of policy and technical changes to the mandatory Radiation Oncology model. Additional details are available here.
- ESRD: The proposed rule contained several potential changes to the mandatory ESRD Treatment Choices model, which the Administration is aiming to update to better address health disparities in kidney care. Details are available here.
Beyond Medicare payment updates, an interim final rule that would address COVID-19 health care staff vaccinations also arrived at OMB last week. The new regulations would be pursuant to President Biden’s recently released “Path out of the Pandemic,” which included plans for requiring COVID-19 vaccinations for all health care workers at Medicare and Medicaid participating hospitals and other health care settings (details).